Christopher Kingsland, 45, of Shipdham Road in Toftwood, near Dereham, died at the Norfolk and Norwich University Hospital (NNUH) in the early hours of October 9 last year, just hours after undergoing gall bladder removal surgery, called a cholecystectomy.

Evidence surrounding the cause of death was disputed at his inquest at Norfolk Coroner’s Court in Norwich on Friday, after a post-mortem examination, carried out by pathologist Rajesh Logasundaram, found Mr Kingsland had 2.3 litres of blood clot and 1.2 litres of blood in his abdominal area.

In the post-mortem report, the cause of death was given as the presence of blood in the peritoneal cavity due to the surgery.

But emergency general surgery consultant Luke Evans, who had seen Mr Kingsland after he underwent surgery, said he did not believe he died of blood loss alone.

Giving evidence in court, Mr Evans said Mr Kingsland had been showing signs of sepsis, namely a high white blood cell count, low blood pressure, high acid levels in his blood and the state of being in shock.

Mr Evans inserted a camera into Mr Kingsland’s abdomen and found clotted blood but no active bleeding.

When asked by senior coroner Jacqueline Lake whether he thought sepsis could be present without physical signs during post mortem, he said: “Absolutely - the amount of blood loss doesn’t fully explain in itself why somebody became so profoundly unwell so soon after surgery.”

Ms Lake called for a short break to consider the cause of death and spoke to pathologist Mr Logasundaram via telephone.

After reconvening the hearing, she told the court that Mr Logasundaram was adamant the blood loss was the prime cause of death and that sepsis could have been a contributory factor, but that there was no overwhelming evidence of it at the post-mortem stage.

In her summary, Ms Lake accepted that sepsis was a contributory factor and it will be added to Mr Kingsland’s cause of death.

She concluded that Mr Kingsland died following a rare but recognised risk of appropriate surgery.